A report analyzing 2023 Medicare Advantage (MA) prior authorization data found that appeals to initial denials led to the denial being partially or fully overturned 81.7 percent of the time. It also found, however, that only 11.4 percent of denials were appealed.
The report by health policy research, polling, and news source KFF said that in 2023, MA plans denied (in whole or in part) 6.4 percent of prior authorization requests, a reduction from 7.4 percent in 2022.
To read the report, visit “Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023.”
